advancing minimally invasive oncologic surgery...using robotics to remove gi tumors with minimally...

P A T I E N T C A R E / E D U C A T I O N / R E S E A R C H / C O M M U N I T Y S E R V I C E NEWS UPDATE FROM THE

DEPARTMENT OF SURGERY

STONY BROOK UNIVERSITY

MEDICAL CENTER

SPRING-SUMMER 2010

NUMBER 26

continued on Page 2

continued on Page 3

In this issue . . .

Introducing OurNew Full-Time Faculty— Colorectal Surgeon— Podiatric Surgeon

Our New Smithtown Offi ceIs Now Open

New High-Risk SurveillanceProgram for Breast Cancer

New Director of ReconstructiveBreast Surgery Appointed

Genetic Research AimedAt Biologic Coronary Bypass

Conducting New Clinical TrialsTo Advance Surgical Care

General Surgery ResidencyGains Continued Accreditation

Pediatric Surgery LectureshipTo Honor Dr. Cedric Priebe

Offering CME Credits

Division Briefs &Alumni News

Advancing Minimally Invasive Oncologic Surgery First Use of New Treatment for Pancreatic Tumors,Performing Surgery at the Cellular Level

The Department’s Upper Gastrointestinal and General Oncologic Surgery Group last December performed a history-making pancreatic procedure at Stony Brook University Medical Center, utilizing irreversible elec-troporation (IRE), a new minimally invasive surgical technique that selectively

kills tumor cells by using electrical fi elds to make holes in cell membranes.

Our utilization of the newly developed IRE technology to treat a patient with unre-sectable pancreatic cancer constitutes the fi rst use of IRE tumor ablation to treat the typically fast-growing

and fatal cancer that occurs in the pancreas.

Kevin T. Watkins, MD, assis-tant professor of surgery and chief of upper gastrointestinal and general oncologic surgery, performed the IRE procedure in combination with a minimally invasive pancreatic resection, which in his experienced hands was done without event.

Dr. Watkins described the prom-ising post-op news:

“Our fi rst IRE patient had her six-week follow-up PET scan in early February, and the initial report showed no activity, making her a radiographic complete response at this point.

Dr. A. Laurie Shroyer Named Vice Chair for ResearchAdvancing Scientifi c KnowledgeTo Improve Patient Care

We are very pleased to an-nounce that A. Laurie W. Shroyer, PhD, MSHA, has joined our faculty as pro-fessor of surgery and vice chair for research. In the newly created position, Dr. Shroyer will work closely with the Department’s faculty and staff team members to integrate basic, translational, and clinical science research endeavors.

“The success of our research enterprise is the key to our success as an academic depart-ment. Dr. Shroyer’s back-ground and experience are ideally suited to advance this effort,” says Todd K. Rosen-gart, MD, professor and chair-man of surgery. “She will be introducing a number of new initiatives to build an enhanced research infrastructure in the coming months.”

IRE kills tumor cells without causing collateral damage to adjacent tissue.

A nationally recognized clinical science researcher, Dr. Shroyer originally joined the School of Medicine, in 2007, as professor of preventive medicine in the Division of Evaluative Sciences.

National fi gure in clinical out-comes research and in translation-al and clinical science education joins our faculty.

42711rev PO ISSUE 26.indd 142711rev PO ISSUE 26.indd 1 5/20/10 9:32:44 AM5/20/10 9:32:44 AM

2 DEPARTMENT OF SURGERY I STONY BROOK UNIVERSITY MEDICAL CENTER I STONY BROOK UNIVERSITY

Advancing Minimally Invasive Oncologic Surgerycontinued from Page 1 “Hopefully, she’ll have a durable response, which only time will tell, but from a local disease standpoint, the tech-nology did just what we had hoped.”

The combination of minimally invasive surgery and IRE allows for faster recovery with less tissue injury and, it is hoped, a better long-term out-come. At a minimum, patient quality of life should improve in the near term.

IRE is a new minimally invasive surgical technique that poten-tially can eliminate soft-tissue cancer tumors without collateral damage to surrounding healthy tissue.

The high-tech system that generates IRE, called Nano-Knife, is approved by the Food and Drug Administration (FDA) for the ablation of soft tissue. It is currently being used for lung, liver, prostate, and kidney tumors, as well.

Dr. Watkins hopes to develop national trials approved by the FDA to demonstrate the ef-fectiveness of this technology. At present, IRE is reserved for patients who do not have good standard treatment options.

IRE technology allows for extreme precision. While targeted soft-tissue cells are killed, blood vessels and other important structures in the area remain functional. The body is able to naturally rid itself of the dead cells. In regenerating organs, such as the liver, the dead cells are replaced with healthy cells.

The “nano” aspect of the IRE procedure is that bursts of electricity create infi nitesimal holes in the walls of the cells of the targeted area, causing cancer cells in this region to die naturally and be normally discarded by the body.

As one of the most important new soft-tissue tumor ablation tools, IRE technology offers

certain advantages over other technologies—advantages that can both make the procedure easier for patients to tolerate and potentially lead to better results.

Because of its precision, IRE may be able to eliminate an entire tumor, leaving patients cancer-free. This is the hope offered by this new form of surgical ablation.

IRE technology does not generate heat or cold, which potentially could damage normal adjacent tissues. This feature adds considerable value to it, together with its ability to selectively induce cell death on soft tissue.

CELLULAR SURGERYElectroporation is the process of using brief and controlled electric pulses to open mi-croscopic pores in a targeted area. By increasing the num-ber, strength, and duration of electric pulses, electropora-tion can be made permanent, or irreversible.

After IRE, the pores in the cells remain open permanent-ly. This causes microscopic damage to the cells, and they die.

IRE promises to be a major advance in cancer treatment, as it can selectively kill tumor cells while leaving critical structures such as nerves and blood vessels intact.

NanoKnife—the system used to achieve IRE—is not really a knife at all, but yet another new use of nanotechnology, the science of dealing with particles and dimensions down to the atomic level.

The NanoKnife system comprises needle-like steel probes (n = 1-6) with an electrical generator and a footswitch to operate it. The probes are single-use dispos-able electrodes.

For consultations/appointments with our specialists in upper gastrointestinal and general oncologic surgery, please call (631) 444-8086.

Using Robotics to Remove GI Tumors With Minimally Invasive Surgery

More patients with complex tumors of the upper gastrointestinal (GI) tract are benefi ting from our use of other recent advances in minimally invasive surgery, including robotically-assisted surgery. Using the new robotics with minimally invasive surgery to remove tumors of the upper GI tract further demonstrates our commitment to excel-lence in patient care, and also to the development of the best ideas in medicine, helping to lead the fi eld of surgery with new advances.

Our surgical oncologists are among the very few surgeons nationwide performing robotically-assisted pancreatico-duodenectomy, known as the Whipple procedure, to remove pancreatic tumors and other types of GI tumors.

The Whipple procedure is one of hardest GI procedures to perform, either by means of conventional open surgery, or by the minimally invasive laparoscopic approach.

Performing this procedure successfully with the robot is a signifi cant surgical feat from the technical point of view, and it offers patients considerable benefi ts.

Kevin T. Watkins, MD, chief of our Upper Gastrointestinal and General Oncologic Surgery Group, says that in general the new minimally inva-sive procedures using robotics offer patients the possibility of dimin-ished postoperative pain, less scarring, fewer complications post-surgery, and earlier discharge from the hospital.

The new approach may also help patients heal quicker, which may be crucial if they need to undergo additional treatment such as chemo-therapy or radiation.

During the Whipple procedure, a portion of the pancreas—the fi rst por-tion of the intestine and the last portion of the bile duct—is removed to treat tumors of these organs.

Despite the laparoscopic instrumentation used in the minimally invasive approach to performing the Whipple, the surgeon is often not able to complete the procedure effectively enough, particularly the reconstruc-tion of the intestinal system.

The use of the da Vinci surgical robot allows reconstruction to be per-formed accurately and in a more minimally invasive way. At Stony Brook, increasing numbers of patients with cancer are being treated with sur-gery using robotics, and are benefi ting from this new advance in care.



Introducing Our New Vice Chair for Researchcontinued from Page 1

POST-OP is published byThe Department of Surgery

Stony Brook UniversityMedical Center

Stony Brook, New York

Editor-in-ChiefTodd K. Rosengart, MD

Writer/Editor

Jonathan Cohen, PhD

Advisory BoardRoberto Bergamaschi, MD, PhD

Alexander B. Dagum, MDThomas K. Lee, MDBrian J. O’Hea, MD

David A. Schessel, MD, PhDMarc J. Shapiro, MD

A. Laurie Shroyer, PhD, MSHAApostolos K. Tassiopoulos, MD

Kevin T. Watkins, MD

All correspondence should be sent to:Dr. Jonathan Cohen

Writer/Editor, POST-OPDepartment of SurgeryStony Brook University

Stony Brook, NY 11794-8191

GRATEFUL ACKNOWLEDGMENT IS MADE TO ANGIODYNAMICSFOR USE OF THE NANOKNIFE ILLUSTRATION ON PAGE 1, AND

TO KATHLEEN GEBHART OF SBU MEDIA SERVICES FORCREATING THE BIOLOGIC BYPASS IMAGE ON PAGE 9.

In addition to serving as the director of the PhD program in population health and clinical outcomes research, Dr. Shroyer has participated as a core faculty member in the master’s program in public health.

With her research endeavors for the U.S. Department of Veterans Affairs based at the Northport VA Medical Cen-ter’s Offi ce of Research and Development, Dr. Shroyer will continue her role as co-principal investigator of the VA Cooperative Studies Program “Revascularization On- and Off-Bypass” (ROO-BY) study.

Last November, Dr. Shroyer published a landmark ROO-BY study, titled “On-Pump versus Off-Pump Coronary-Artery Bypass Surgery,” in the New England Journal of Medicine. This national trial, which took six years to complete, was a controlled, single-blind, randomized trial conducted at 18 VA medical centers. Dr. Shroyer is the fi rst author of the report.

The LCME, sponsored by the Association of American Medical Colleges and the American Medical Associa-tion, is the nationally recog-nized accrediting author-ity for medical education programs leading to the MD degree in U.S. and Canadian medical schools.

As assistant dean, Dr. Shroyer also serves as co-director of the school’s new Professional Development Program, which includes research, education, and leadership components, as well as completion of a men-tored academic project.

Dr. Shroyer received her PhD in public administra-tion (concentration in health policy) and her MS in health administration (concentra-tion in fi nancial manage-ment) from the University of Colorado.

A prolifi c author, Dr. Shroyer has published 126 research articles to date in the biomedical literature. Her specifi c interests include improving patient quality of care, refi ning risk-adjust-ment approaches to assess clinical outcomes, evaluat-ing the cost-effectiveness of healthcare services, and supporting clinician-scientist research training and educa-tion programs.

Our New Smithtown Offi ceOpened on May 5

Dr. Shroyer’s recent report in the New England Journal of Medicine examining the outcomes of off-pump versus on-pump coronary bypass surgery—the fi rst published conclusive trial comparing these different approaches—made national news.

Through March 2009, Dr. Shroyer co-directed the VA’s Continuous Improvement in Cardiac Surgery Program (CICSP). Additionally, she has served on the Society of Thoracic Surgeons (STS) National Databases working group.

Given the leading role of both the VA CICSP and the STS databases in forging the fron-tier of quality improvements related to cardiac surgery, she gained a national reputa-tion for advancing the fi eld of clinical outcomes research.

“My overarching vision for the Department of Surgery’s research enterprise is to advance scientifi c knowledge to improve patient care and population health, as well as to foster opportunities for training in research for the next generation of surgical investigators,” says Dr. Shroyer.

Dr. Shroyer has also been appointed assistant dean for educational research in the School of Medicine. In this additional leadership position, Dr. Shroyer plays a critical role in the Liaison Committee on Medical Education (LCME) accredi-tation process, as well as in the evaluation and outcomes reporting of student educa-tion, faculty mentoring, and career development.

Dr. A. Laurie Shroyer

MED

IA S

ERVI

CES

| ST

ONY

BROO

K UN

IVER

SITY

Offering Full Range Of Diagnostic And Consultative Services

We are very pleased to announce the opening of our new offi ce for outpatient care in Smithtown, NY. With fi ve exam rooms, two consulta-tion rooms, and one procedure room, this newly constructed offi ce enables us to provide expanded access to our physicians and services.

Breast Surgery• Cardiothoracic Surgery• Colorectal Surgery• General Surgery • Plastic & Reconstructive Surgery• Wound Care•

Conveniently located on “Doctors Row” in Smithtown—at 222 Middle Country Road (Suite 209), just east of the intersection of route 25A and highway 111—the new offi ce offers patients plenty of easy parking. Offi ce hours are from 8:30 am to 5:00 pm, Monday through Friday.

For consultations/appointments at our Smithtown offi ce, please call (631) 444-4545.



Introducing More New Faculty

Colorectal SurgeonDr. William B. SmithyRejoins Our Full-Time Faculty

William B. Smithy, MD, as-sistant professor of surgery, last November rejoined our full-time faculty as a member of the Division of Colon and Rectal Surgery. Dr. Smithy is a distinguished colorectal surgeon with deep roots in our community.

In April, Dr. Smithy was appointed program director of our residency (fellowship) training program in colon and rectal surgery.

Dr. Smithy joins our full-time faculty after having been a member of our voluntary faculty since 2005, and previ-ously having been a member of our full-time faculty from 1988 to 1998.

Most recently, Dr. Smithy has served as medical staff president at St. Catherine of Sienna Medical Center in Smithtown, NY.

Dr. Smithy sees patients at our new Smithtown offi ce, as well as at our Surgical Care Center in East Setauket.

Dr. Smithy received his MD from Columbia University in 1981. He completed his residency training in gen-eral surgery at St. Luke’s-Roosevelt Hospital Center in 1987, and then went on to do his fellowship training in colon and rectal surgery at Robert Wood Johnson University Hospital.

Board certifi ed in both colon and rectal surgery and general surgery, Dr. Smithy provides a full range of consultative, diagnostic, and therapeutic services involv-ing surgery for patients with diseases of the small bowel, colon, rectum, and anus.

Dr. Smithy’s operative skills include use of laparoscopic minimally invasive surgery and other minimally invasive procedures for the treatment of colorectal diseases. Long recognized as one of the “Doctors of Excellence” in our region, Dr. Smithy has been selected for inclusion in past editions and in the latest edition (2010) of the Castle Connolly Guide, Top Doctors: New York Metro Area.

For consultations/appointments with Dr. Smithy, please call (631) 444-4545.

Podiatric SurgeonDr. Valerie A. BrunettiJoins Our Full-Time Faculty

Valerie A. Brunetti, DPM, assistant professor of sur-gery, in January joined our full-time faculty as a member of the Division of Vascular Surgery. Dr. Brunetti has been an active member of our part-time faculty since 2002, serving as founding director of our podiatric surgery service.

Board certifi ed in podiatric surgery, Dr. Brunetti pro-vides evaluation and treat-ment of the foot and ankle, both in the hospital and on an outpatient basis.

Dr. Brunetti has operating room privileges at University Hospital and at the Stony Brook Ambulatory Surgery Center. Additionally, she is an active member of the mul-tidisciplinary Wound Center at the Surgical Care Center in East Setauket, NY, where she provides foot/ankle con-sultations and treatment.

MED

IA S

ERVI

CES

| ST

ONY

BROO

K UN

IVER

SITY Dr. Brunetti’s foot care ser-

vices include palliative and/or surgical treatment of in-fections (soft tissue or bone) or ulcerations of the foot; diabetic foot; biomechani-cal imbalances including bunions and hammertoes; hypertrophied mycotic nails and pedal hyperkeratosis; heel pain, gouty arthritis, and Charcot foot deformities.

Dr. Brunetti received her DPM from the New York College of Podiatric Medi-cine in 1984, and completed her surgical residency at Manhattan hospitals affi li-ated with NYCPM. She then spent the academic year of 1986–87 as dean of podiatric medicine at Barry University in Miami Shores, FL.

Returning to New York, she entered private practice, and subsequently joined the faculty of NYCPM.

In 1992, Dr. Brunetti joined the staff of the Northport Veterans Affairs Medical Center, as chief of podiatry and director of the podiatric residency program. She joined our part-time faculty ten years later, splitting her time between Stony Brook and the VA. Now she works here exclusively.

Dr. Brunetti is a diplomate of the American Board of Podiatric Surgery and fellow of the American College of Foot and Ankle Surgeons.

For consultations/appointments with Dr. Brunetti, please call (631) 444-4545.

Dr. Brunetti contributes herexpertise to the comprehensive, multidisciplinary care providedby our Wound Center.



Carol M. Baldwin Breast Care CenterStarts High-Risk Surveillance ProgramProviding the Most Sophisticated CareFor Women with Breast Cancer Risk Factors

The new High-Risk Surveil-lance Program is a unique, multidisciplinary program for women who are at increased risk of develop-ing breast cancer over the course of their lives. Women in the program are offered not only preventive strate-gies, but also services that include earlier detection of breast cancer, as well as the option to be involved in clini-cal trials.

Our new surveillance program aims to give women peace of mind through genetic counseling and screenings with the most sophisticated technologies.

“Certain women are at increased risk for developing breast cancer due to per-sonal or family history,” says breast surgeon Christine R. Rizk, MD, assistant profes-sor of surgery, who joined our faculty last fall (coming from Roswell Park Cancer Institute). “Our new surveil-lance program aims to give these women peace of mind through genetic counseling and cancer screenings with the most sophisticated tech-nologies.”

Women who have a personal or family history that meets the following criteria are in-vited to enter our High-Risk Surveillance Program:

SERVICES & OPTIONSWomen who enter our High-Risk Surveillance Program are provided a range of care to help ensure their wellness—all in a sensitive and respectful manner. The active involvement of our patients in their care is essential to the success of the program, which offers them the following services and options:

Initial Consultation The fi rst consultation takes place at the Carol M. Baldwin Breast Care Center at Stony Brook. A detailed family history is obtained, as well as a review of any previous breast biopsies. Patients are examined by a breast surgeon, and the patient’s most recent breast imaging is reviewed.

Based on actual risk, various preventive strategies may be considered. They include possible chemoprevention with cer-tain medications, such as tamoxifen (Nolvadex) and raloxifen (Evista). Furthermore, the relative merits of additional screen-ing modalities (breast ultrasound and MRI) are considered. Patients are also educated in breast self-examination so that they are confi dent in performing self-exam.

Genetic Counseling If indicated, genetic counseling can be arranged with an on-site genetic counselor. This counseling provides a full range of services, including complete informed consent prior to testing, as well as discussion with the patient regarding ramifi cation of a positive test. Some patients may be tested for a variety of genetic mutations, including BRCA-1, BRCA-2, PTEN, and P53 mutations.

Preventive SurgeryWhen indicated, based on genetic testing, patients are coun-seled regarding prophylactic breast surgery. Additionally, when indicated, referrals are made to appropriate specialists for other kinds of preventive surgery, including gynecologic, colorectal, and endocrine surgeons.

Clinical Trials Patients in our High-Risk Surveillance Program have the opportunity to be part of ongoing clinical trials and research studies. This scientifi c work aimed at improving patient care

Breast cancer is the most commonly diagnosed cancer among women. According to the National Cancer Institute, one in every eight women in the United States will receive a diagnosis of breast cancer during her lifetime. To further help the women of our community to beat these odds, we have created the High-Risk Surveillance Program at the Carol M. Baldwin Breast Care Center.

A personal history of an • abnormal breast biopsy, including atypia and lobular carcinoma in situ (LCIS), or personal history of breast cancer.

A family history with • breast cancer in a fi rst-degree relative (mother, sister, daughter, father).

Multiple second-degree • relatives with breast cancer (grandmother, aunt) on either side of the family.

History of radiation to the • chest (mantle radiation).

A known genetic mutation • in the family, including breast cancer (BRCA)-1 or -2 gene mutation.

Brian J. O’Hea, MD, associ-ate professor of surgery, chief of breast surgery, and director of the Baldwin Breast Care Center, explains that we have expanded our surveillance care for high-risk women into a more formalized, comprehensive high-risk screening program to best serve our community.

Amedeo Modigliani (1918)



Since joining our faculty in 2004, Dr. Bui has distin-guished himself as a skilled clinician who is greatly respected by his colleagues. Board certifi ed in both general surgery and plastic surgery, Dr. Bui has been honored by inclusion in the latest editions of the Con-sumers’ Research Council of America Guide to America’s Top Plastic Surgeons.

Last fall, Dr. Bui’s research program won signifi cant recognition from the Carol M. Baldwin Foundation for Breast Cancer Research, which awarded him a two-year grant to conduct his clinical study titled “Compari-son of Intraoperative Meth-ods to Predict Mastectomy Skin Flap Necrosis” (see page 8).

Dr. Bui joined our Division of Plastic and Reconstructive Surgery in 2004. He came to Stony Brook from Memorial

may include novel screening methods and technology, as well as studies examining risk-reduction strategies.

Nutritional EducationPatients are offered nutri-tional education as well as in-formation on healthy lifestyle that may reduce their risk of developing breast cancer. A registered dietitian reviews strategies for weight reduc-tion, exercise, and nutritional guidelines, and also answers any questions that patients may have.

Psychosocial Support Patients enrolled in our pro-gram have the opportunity to attend support groups and meet with social workers, if needed, to help manage the psychosocial stress that can result at times in this group of “high risk” women. Patients also have the oppor-tunity to take yoga classes at the Baldwin Breast Care Center to help with stress reduction.

Our new High-Risk Surveil-lance Program aims to provide the most sophisticated and consistent screening and follow-up for breast cancer survivors and women with high-risk factors for breast cancer. This program enhanc-es the complete, state-of-the-art, and comprehensive breast care to which our physicians and staff are dedicated. And it further demonstrates the Carol M. Baldwin Breast Care Center’s commitment to excellence in patient care.

All of our breast surgeons partici-pate in the High-Risk Surveillance Program. For more information—and for consultations/appoint-ments—please call (631) 638-1000.

Dr. Duc T. Bui Appointed DirectorOf Reconstructive Breast Surgery

We are very pleased to an-nounce the appointment of Duc T. Bui, MD, assistant professor of surgery, as director of reconstructive breast surgery.

In his new role, Dr. Bui will continue to expand and bring energetic leadership to the busiest reconstructive breast surgery service on Long Island. He will incorporate his specifi c clinical interests, leading-edge research initia-tives, and multidisciplinary team approach to provide the best in patient care.

Sloan-Kettering Cancer Cen-ter, where he completed his breast surgery/microsurgery fellowship, gaining advanced skills in breast reconstruction.

Dr. Bui received his MD from the Weill Medical College of Cornell University in 1995. He completed his residency train-ing in general surgery at New York Presbyterian Hospital-Cornell Medical Center, and his training in plastic surgery at the University of California at San Francisco.

Dr. Bui’s two-year fellowship at Memorial Sloan-Kettering focused on microsurgery and breast reconstruction. His successful experience there also led to several impressive peer-reviewed publications related to advances in breast reconstruction.

For consultations/appointments with Dr. Bui, please call (631) 444-4666.

MED

IA S

ERVI

CES

| ST

ONY

BROO

K UN

IVER

SITY

Dr. Duc T. Bui

Our Second Annual Surgical Jeopardy, held

in January, was a big hit! The three-man

faculty team that played against the top resident

team was victorious in the Final Jeopardy round. This game is

modeled in format after the popular TV show

and in content after a game created by the American College of

Surgeons to test and increase surgeons’

knowledge.

DoubleJeopardyRound



To Use CT Scans, or Not:Considering Risks versus Benefi tsMessage from Dr. Thomas V. Bilfi ngerOf Lung Cancer Evaluation Center

Thomas V. Bilfi nger, MD, ScD, professor of surgery and director of thoracic surgery, is director of the Lung Cancer Evaluation Center at Stony Brook:

Recently, the news media has drawn attention to reports in medical journals that warn of deleterious effects that may occur after repeat radiation exposure from advanced im-aging modalities often used in medical practice.

is based on estimates from radiation exposure data that date back to measurements made in Hiroshima.

We at the Lung Cancer Evaluation Center at Stony Brook have been aware of these reports, and are striv-ing to limit the amount of exposure for our patients.

Having said that, however, it has to be recognized that CT scans have been the most helpful advance in the detection of lung cancer in the last 50 years.

A patient with a newly de-tected lung cancer without treatment has an approxi-mate life expectancy of 18 months, which has to be contrasted to the forma-tion of cancer from these advanced imaging studies occurring 20 to 40 years in the future.

We encourage our patients to ask about the necessity of these studies if they feel that they occur too often. We are making every effort to keep them to a mini-mum, keeping in mind our primary goal, which is to detect and treat new lung cancers and recurrences as early as possible.

For more information, please call the Lung Cancer Evaluation Center at (631) 444-2981.

The most recent reports add to a growing body of information that has become available, pointing out that computed tomographic (CT) scans expose the patient to an amount of radiation, which, if cumulative, by and of itself can be deleterious and lead to cancer.

Although no direct cause-effect link between imaging technology and cancer has yet been proven, the concern

Altomare DF, Guanti G, Hoch J, Vician M, Krivokapic Z, Bergamaschi R; for the Colorectal Micrometastases Study Group. Non-colonic cancer stem cells in bone marrow of colorectal cancer patients. Colorectal Dis 2010;12:206-12.

Bao P, Bartlett D. Surgical techniques in visceral resection and peritonectomy procedures. Cancer J 2009;15:204-11.

Bergamaschi R, Haughn C, Reed JF 3rd, Arnaud JP. Laparoscopic intracorpo-real ileocolic resection for Crohn’s disease: is it safe? Dis Colon Rectum 2009;52:651-6.

Boyd JB, Gelfand M, Da Lio A, Shaw W, Watson JP. Comparison of superior gluteal artery musculocutaneous and superior gluteal artery perfora-tor fl aps for microvascular breast reconstruction. Plast Reconstr Surg 2009;123:1641-7.

Caso G, McNurlan MA. Effect of insulin on whole body protein metabolism in children with type 1 diabetes. Curr Opin Clin Nutr Metab Care 2010;13:93-6.

Caso G, Mileva I, Kelly P, Ahn H, Gelato MC, McNurlan MA. Feeding acutely stimulates fi brinogen synthesis in healthy young and elderly adults. J Nutr 2009;139:2032-6.

Caso G, Mileva I, McNurlan MA, Mynarcik DC, Darras F, Gelato MC. Effect of ritonavir and atazanavir on human subcutaneous preadipocyte proliferation and differentiation. Anti-viral Res 2010;86:137-43.

Dagum AB, Park DJ, Lau KN, Khan SU. Antibiotic-impregnated polymethyl-methacrylate beads and cement in the treatment of posttraumatic infections of the frontal sinus. Plast Reconstr Surg 2009;123:193e-4e.

Denoya P, Wang H, Sands D, Nogueras J, Weiss E, Wexner SD. Short-term outcomes of laparoscopic total me-sorectal excision following neoadju-vant chemoradiotherapy. Surg Endosc 2010;24:933-8.

Denoya PI, Weiss EG. Surgery for pilonidal disease and hydradenitis suppurativa. In: Whitlow CB, Beck DE, Margolin DA, Hicks TC, editors. Improved Outcomes in Colon and Rectal Surgery. New York: Informa Healthcare, 2009: 215-25.

Essani R, Scriven RJ, McLarty AJ, Merriam LT, Ahn H, Bergamaschi R. Simulated laparoscopic sigmoidec-tomy training: responsiveness of surgery residents. Dis Colon Rectum 2009;52:1956-61.

Gelfand DV, Tassiopoulos AK, Wilson SE. Surveillance, revision, and out-come of vascular access procedures for hemodialysis. In: Wilson SE, editor. Vascular Access: Principles and Prac-tice. 5th ed. Philadelphia: Lippincott, Williams & Wilkins, 2010: 150-4.

Huston JM, Eachempati SR, Rodney JR, Cayci C, Fusco D, Mathew M, Shou J, Goldstein MJ, Kapur S, Barie PS. Treatment of Strongyloides stercoralis hyperinfection-associated septic shock and acute respiratory distress syndrome with drotrecogin alfa (acti-vated) in a renal transplant recipient. Transpl Infect Dis 2009;11:277-80.

Selected RecentPublications*

Huston JM, Rosas-Ballina M, Xue X, Dowling O, Ochani K, Ochani M, Ye-boah MM, Chatterjee PK, Tracey KJ, Metz CN. Cholinergic neural signals to the spleen down-regulate leukocyte traffi cking via CD11b. J Immunol 2009;183:552-9.

Jacob ZC, Tito MF, Dagum AB. MR imaging-related electrical thermal injury complicated by acute carpal tun-nel and compartment syndrome: case report. Radiology 2010;254:846-50.

Labropoulos N, Gasparis AP, Tas-siopoulos AK. Prospective evalu-ation of the clinical deterioration in post-thrombotic limbs. J Vasc Surg 2009;50:826-30.

Pahk R, Azu MC, Taira BR, Sandoval S. Antiretroviral-induced toxic epidermal necrolysis in a patient positive for hu-man immunodefi ciency virus. Clin Exp Dermatol 2009;34:e775-7.

Ruggieri F, Caso G, Wegmann M, McNurlan MA, Wahl C, Imoberdorf R, Garlick PJ, Ballmer PE. Does increasing blood pH stimulate protein synthesis in dialysis patients? Nephron Clin Pract 2009;112:c276-83.

Schiller J, McCormack JE, Tarsia V, Shapiro MJ, Singer AJ, Thode HC Jr, Henry MC. The effect of adding a sec-ond helicopter on trauma-related mor-tality in a county-based trauma system. Prehosp Emerg Care 2009;13:437-43.

Shapiro MJ. Thoracic and abdominal trauma. In: Rehm CG, editor. Adult Multi-Professional Critical Care Review. Mount Prospect, IL: Society of Critical Care Medicine, 2009: 203-18.

Shawki S, Bashankaev B, Denoya P, Seo C, Weiss EG, Wexner SD. What is the defi nition of “conversion” in laparoscopic colorectal surgery? Surg Endosc 2009;23:2321-6.

Shroyer AL, Grover FL, Hattler B, Collins JF, McDonald GO, Kozora E, Lucke JC, Baltz JH, Novitzky D; Veterans Affairs Randomized On/Off Bypass (ROOBY) Study Group. On-pump versus off-pump coronary-artery bypass surgery. N Engl J Med 2009;361:1827-37.

Szema AM, Paz G, Merriam L, Stellaccio F, Jen J. Modern preoperative and intraoperative management of heredi-tary angioedema. Allergy Asthma Proc 2009;30:338-42.

Taira BR, Fenton KE, Lee TK, Meng H, McCormack JE, Huang E, Singer AJ, Scriven RJ, Shapiro MJ. Ventilator-associated pneumonia in pediatric trauma patients. Pediatr Crit Care Med 2009;10:491-4.

Wang H, Safar B, Wexner S, Denoya P, Cruz-Correa M, Berho M. The clinical signifi cance of fat clearance lymph node harvest for invasive rectal adenocarcinoma following neoadjuvant therapy. Dis Colon Rectum 2009;52:1767-73.

Wu GS, Gilet A, Kirshbaum M, Bilfi nger T, Ferretti J. Inferior vena cava fi lter migration with severe deformity of fi l-ter. J Vasc Interv Radiol 2009;20:1257-9.

Zemlyak A, Hwang S, Chalas E, Pa-meijer CR. Primary extrauterine endometrial stromal sarcoma: a case and review. J Gastrointest Cancer 2009;39:104-6.

Dr. Thomas V. Bilfi nger

* The names of faculty authors appear in boldface.

MED

IA S

ERVI

CES

| ST

ONY

BROO

K UN

IVER

SITY


8 DEPARTMENT OF SURGERY I STONY BROOK UNIVERSITY MEDICAL CENTER I STONY BROOK UNIVERSITY8 8 D DEPEPARRTMT ENT OFOF SSURURGEGERYRY I I SSTOONYNY B BROROOKOK U UNINIVEVERSRSITITYY MEMEDIDICACAL L CECENTNTERER I I S STOTONYNY B BROROOKOK U UNININ VEVERSRSITITYY

Measuring Blood Flow in SkinFor Reconstructive Breast Surgery

Aiming to Achieve the Best PossibleSurgical Outcome for Women

More than 250,000 American women face the realities of breast cancer each year. More options, advancements in treatments, and recon-structive surgery have led to physical and emotional outcomes that are much bet-ter than what they were in the past.

For women facing the complete loss of one or both breasts, the benefi ts of breast reconstruction can be related to self-esteem and maintaining a positive body image. The restoration of a woman’s feeling of being whole again is important.

New York law requires that every woman undergoing a mastectomy be offered recon-structive breast surgery.

Most women who undergo breast removal because of cancer can have reconstruc-tive surgery. Reconstructive surgery is considered to be a very safe option, but like any surgery, it is associated with certain risks of complica-tions such as bleeding, fl uid build-up, poor wound heal-ing, and partial or complete tissue death.

Serious complications can lead to the loss of the recon-structed breast or need for additional surgery.

Performing Clinical Trials to Advance Patient CareOur faculty is committed to excellence in research, in order to fi nd new and better treatments for our patients, as part of our commitment to excellence in patient care.

We currently are perform-ing some 30 clinical trials to evaluate the effectiveness of potentially new treatment options related to the surgical specialties represented by our physicians.

Our goal is to give patients the opportunity to participate in approved and exploratory therapies without long-dis-tance travel.

Our clinical trials enable us to use, in addition to established therapies, the newest and most advanced technologies and treatments—long before they are available to other physicians.

Patients participate in our clinical trials only after they receive a complete explana-tion of their options from their surgeon and surgical team.

Patient volunteers are needed for our clinical trial of minimally invasive methods of measuring blood fl ow in skin used for reconstructive breast surgery.

Surgeons report that many of the complications associated with breast reconstruction can be traced back to poor blood fl ow in the vessels that deliver blood to tissue, or poor circulation in the tissue left behind following the mastectomy.

Our plastic surgeons and breast surgeons have ini-tiated a clinical trial to evaluate the effectiveness of two minimally inva-sive imaging techniques for measuring blood fl ow in skin used for recon-structive breast surgery following mastectomy.

This study, titled “Com-parison of Intraoperative Methods to Predict Mastec-tomy Skin Flap Necrosis,” is funded by the Carol M. Bald-win Foundation for Breast Cancer Research, which recently awarded a two-year grant to Duc T. Bui, MD, as-sistant professor surgery and director of reconstructive breast surgery.

With our reconstructive surgery, a breast that closely approximates the form, feel,

and appearance of a normal breast can be created.

Dr. Bui, the study’s principal investigator, explains: “The ability to predict and prevent skin necrosis [tissue death] has the potential to prevent signifi cant physical and psychological pain for breast cancer patients, as well as substantial costs.”

“The specifi c aim of this study,” he says, “is to com-pare the Novadaq SPY imag-ing system and fl uorescein dye angiography as quanti-tative tools versus clinical assessment of mastectomy skin fl ap perfusion.”

Both of these assessment tools are minimally invasive. The SPY technology is rela-tively new and its effective-ness is well proven in other surgical applications. The an-giographic method has been used effectively for decades in plastic surgery and other surgical fi elds.

The ability to accurately assess circulation in tissue, particularly the tissue left be-hind after mastectomy, might also enable more patients to be candidates for immediate reconstruction.

PPPPPPPP f i Cli ii ll

Participation in our clinical trials is always completely voluntary, and never interferes with the normal standards for patient care.

For information about our current clinical trials, or to refer a patient, please call our clinical research coordinator Eileen Finnin, RN, at (631) 444-5454.



Conducting Genetic ResearchTo Enhance ArteriogenesisAiming to Help the Heart CreateIts Own Coronary Bypass

Arteriogenesis is the de-velopment of mature blood vessels supported by smooth muscle. This natural process usually occurs in response to occlusion (blockage) of blood fl ow within a vessel, and results in the formation of collateral vessels that bypass the blockage, thus allowing blood fl ow to return to the affected area.

Arteriogenesis has the po-tential to lessen the impact of myocardial infarction (heart attack), and thereby reduce the effects of heart disease, which is the leading cause of death in the United States.

Unfortunately, arteriogen-esis has two major draw-backs. First, vessel formation takes a signifi cant amount of time. Often the slow process results in catastrophic injury before the collateral system is in place. Second, even in the event of successful col-lateral formation, only 30% to 40% of the original blood fl ow capacity is restored.

The research team directed by Todd K. Rosengart, MD, profes-sor and chairman of surgery and chief of cardiothoracic surgery, is now conducting basic and translational studies that aim to shed light on the underlying process of arterio-genesis in order to overcome its limitations.

Dr. Rosengart’s research focuses primarily on the early growth response (Egr-1) gene. Current research sug-gests that this gene is among the fi rst activated in response to the physical stimuli, such as increased arterial pressure and fl uid shear stress, which accompany occlusion.

Egr-1 is also known to regu-late many processes crucial to vessel formation such as

endothelial cell proliferation and monocyte/macrophage recruitment to the occlusion site. Research into this gene may resolve how the body translates physical stimuli into genetic pathways that regulate arteriogenesis.

Dr. Rosengart comments: “Ul-timately, through the modula-tion of Egr-1 and its target genes, we hope to improve the body’s response time to oc-clusion, as well as to increase the fi nal blood-fl ow capacity of the collateral network formed by this process. The great potential to save lives offered by such therapy makes it an extremely exciting pursuit for our research team.”

Our Current Clinical Trials Include Studies OfThese Conditions:

Atrial • fi brillation in CABG

Ischemia • in CABG

Skin necrosis • in breast reconstruction

Deep venous • thrombosis

Lung cancer•

Melanoma•

Peripheral • artery disease

Wound healing•

Hemorrhoids•

Conceptualization of angiogenic gene therapy, showing growth of collateral vessels around the occlusion.

Testing New Minimally InvasiveTreatment of Problem HemorrhoidsAiming to Reduce Postoperative PainPlus Disability and Cost

Transanal hemorrhoidal dearteri-alization (THD) is a new minimally invasive procedure that treats the source of hemorrhoids in order to eliminate them. Because no cutting is done to remove hemor-rhoidal tissue, there is minimal postoperative pain. THD is done as an outpatient procedure, and enables patients to get back to normal activities quickly.

Our colorectal surgeons are currently conducting a clinical trial—specifi cally, a prospective, randomized, controlled study—to test their hypothesis that third- and fourth-degree internal hemorrhoids can be treated with reduced postoperative pain and disability by THD, compared to standard surgical excision(removal) of hemorrhoids.

Since THD is performed above the nerve bundles, or dentate line, there is very little pain.

Based on published data, THD is a safe and effective procedure. It in-volves the use of Doppler ultrasound to accurately locate the arterial blood infl ow that feeds a hemor-rhoid. With simple suture, the arter-ies are tied off, and the prolapsed tissue is sutured back to anatomical position without excision of tissue.

This clinical trial, it is expected, will result in the signifi cant advance-ment of knowledge with regard to the optimal surgical treatment of hemor-rhoids. By determining a preferred method, it will be possible to offer the best standard of care. The plan is to enroll a total of 60 patients in our current study.

continued on Page 15



Creating the Cedric J. Priebe Jr., MD,Endowed Pediatric Surgery LectureshipAdvancing the Surgical Care Of Children Through Education

We are very pleased to an-nounce the launch of our campaign to establish the Cedric J. Priebe Jr., MD, Endowed Pediatric Surgery Lectureship. The Priebe Lectureship will support an annual visiting professor’s presentation centering on a current clinical or research issue in pediatric surgery.

This lecture presentation, to be given as part of our Surgi-cal Grand Rounds program, will focus on new methods to improve patient care, as well as new research in the fi eld of pediatric surgery.

Support the Priebe Lectureship and help advance the education of surgeons caring for children!

Support of the lectureship fund with charitable dona-tions to the Stony Brook Foundation will help recog-nize Dr. Priebe’s contribution to pediatric surgical care for Long Island children and his long-standing educational commitment.

Our goal is to establish a $100,000 fund, ensuring the longevity of the lectureship. All donations are tax-deduct-ible, and all donations—large or small—will be recognized.

Dr. Cedric J. Priebe Jr. with patient, Daniela.

GERA

LD B

USHA

RT |

DEP

ARTM

ENT O

F SU

RGER

Y Honoring Dr. Priebe, Our Founding Chief Of Pediatric Surgery

Dr. Priebe’s distinguished career as an academic pediat-ric surgeon began when the specialty of pediatric surgery was being developed, and spanned 42 years. He is a graduate of Cornell Medical College and completed a sur-gical residency at Roosevelt Hospital in New York City. He then served in the United States Air Force as a general surgeon.

After caring for a number of complicated pediatric surgical patients, he was motivated to enter a two-year residency in pediatric surgery at Ohio State Uni-versity’s Children’s Hospital in Columbus, directed by H. William Clatworthy Jr., MD.

Dr. Priebe later served on the faculty at Columbia University and developed his research and academic career, which he continued as chief of pediatric surgery at Louisiana State Medical Center and Charity Hospital, and director of surgical edu-cation at Children’s Hospital in New Orleans.

Today, because of Dr. Priebe’s leadership, we educate tomor-row’s surgeons to provide the best care to children.

Dr. Priebe’s experience and expertise positioned him to become, in 1982, the found-ing chief of our Division of Pediatric Surgery. He developed a strong patient care service here, and was recognized as a meticulous surgeon, tireless teacher, and a mentor of surgical fac-ulty, residents, and medical students.

Dr. Priebe retired from clinical practice in 2007. His commitment to excellence in patient care has been recognized by his selec-tion for inclusion in Castle Connolly’s How to Find the Best Doctors—New York Metro Area, the Consum-ers’ Research Council of America’s Guide to America’s Top Surgeons, and Marquis’ Who’s Who in Medicine and Health Care and Who’s Who in America.

His sustained desire to con-stantly improve the surgical care of children has been the dominant force guiding his life. He remains committed to our academic mission of excellence.

For more information about the Priebe Lectureship, please call the Stony Brook University Medical Center Advancement Offi ce at (631) 444-2899.



Since the class of 1975 entered the profession of surgery, 190 physicians have completed their residency training in general surgery at Stony Brook. The alumni of this residency program and our other residency (fellowship) programs now practice surgery throughout the United States, as well as in numerous other countries around the world—and we’re proud of their diverse achievements and contributions to healthcare.

Dr. Robert A. Mason (’79) is in private practice as a vascular surgeon in Saratoga Springs, NY, where he is on staff at Saratoga Hospital.

Dr. Andreas G. Tzakis (’83), who has long been recognized as one of the top transplant surgeons in the world, is director of the Miami Transplant Institute, a joint program at Jackson Memorial Hospital and the University of Miami. The Andreas G. Tzakis Chair in Transplant Surgery, in the University of Miami’s Divi-sion of Transplantation, was recently funded.

Dr. Mary D. Fogerty (’97) is an assistant professor of surgery at Vanderbilt Uni-versity in Nashville, TN, and practices as an attending physician in its burn center, a 25-bed Level 1 regional refer-ral center for both adult and

pediatric patients. She au-thored the following report published last fall: Fogerty M, Guy J, Barbul A, Nanney LB, Abumrad NN. African-Americans show increased risk for pressure ulcers: a retrospective analysis of acute care hospitals in America. Wound Repair Regen 2009;17:678-84.

Her recent presentations include:

The effect of preinjury statin use on mortality and sepsis in elderly burn patients [authors: Fogerty MD, Abumrad N, Efron D, Guy J, Barbul A]. Annual Meeting of the Ameri-can Association for the Surgery of Trauma. Pittsburgh, PA; October 2009.

Epidemiology and risk factors for pressure ulcers [author: Fogerty MD]. Joint Meeting of the Euro-pean Tissue Repair Society and the Wound Healing Society. Limoges, France; August 2009.

Dr. Jonas P. DeMuro (’01) completed a surgical criti-cal care fellowship at North Shore University Hospital in

To submit alumni news online and to fi nd current mailing addresses of our alumni, please visit the Department’s website at www.StonyBrookSurgery.org GENERAL SURGERY ALUMNI: Please send your e-mail address—for inclusion in the Alumni Directory—to [email protected]

Manhasset, NY, during the pre-vious academic year, and has passed the boards in it, as well. Last summer, he joined the surgical faculty at Winthrop-University Hospital in Mineola, NY. He specializes in minimally invasive surgery, trauma, and surgical critical care.

Dr. Roger H. Kim (’07) last June completed his fellowship in surgical oncology at Virginia Commonwealth University in Richmond, VA. In September, he started a full-time faculty position as assistant professor of surgery in the Division of Surgical Oncology at Louisiana State University in Shreveport, LA. He was appointed head of minimally invasive surgery at Feist-Weiller Cancer Center. His recent publications include:

Kim RH, Takabe K, Lockhart CG. A hybrid technique: video-assisted thoracoscopic surgery (VATS) pulmo-nary resections for community-based surgeons. Surg Endosc 2010;24:700-4.

Kim RH, Takabe K, Milstien S, Spiegel S. Export and functions of sphingosine-1-phosphate. Biochim Biophys Acta 2009;1791:692-6.

A personal note: he got mar-ried last May to Sookyung Suh.

Dr. Andrea Zimmern (’09), following her laparoscopic colorectal surgery fellowship at the University of Illinois-Chicago, matched in the colorectal surgery fellowship in Erie, PA.

ALUMNI NEWS

General Surgery Residency Gains Continued AccreditationSuccess of Faculty and Residents Plus This Year’s Match Results

In March, the Accreditation Council for Graduate Medical Education granted our residency training program in general surgery the status of “continued accreditation.” This ac-creditation is based on the examination of data from the past fi ve years that demonstrate the strength of all aspects of our training program, which was conducted earlier this year by the ACGME’s Residency Review Committee for Surgery.

The strength of our residency program derives from the Department’s 36-year history of meeting the high standards of the ACGME, required for accreditation. It also refl ects the continually growing vitality of our faculty, “parent” institu-tion—namely, Stony Brook University Medical Center—and participating institutions, the Veterans Affairs Medical Center in Northport, NY, and Winthrop-University Hospital in Mineola, NY.

Our success in this year’s resident match further demonstrates the status of our program, as general surgery continued to be a very competitive specialty throughout the nation. We received over 600 applications, interviewed 75 candidates, and matched our six “categorical” positions to an outstanding class with an average score of over 90% on the U.S. Medical Licensure Exam.

Conducted annually by the National Resident Match Program, the match uses a computer algorithm designed to produce favorable results for medical students applying for residency training positions in all specialties available at U.S. teaching hospitals.

Ew

ed ng class with an

didadidddt th

dth

sl mal m

RSITYRS

masuthe

idates, and matched l ith

ath

su

TYY

on

and maatches, and matvedh

atio doe

e ngurg

atch



DIVISION BRIEFS

Breast SurgeryDr. Brian J. O’Hea, as-sociate professor of surgery, chief of breast surgery, and director of the Carol M. Baldwin Breast Care Center, was again selected for inclu-sion in the Castle Connolly Guide, America’s Top Doc-tors, published in February. This work identifi es the top 1% of physicians in the United States and refl ects the results of tens of thou-sands of physician respon-dents to Castle Connolly’s nationwide survey process.

In addition, Dr. O’Hea was again selected for inclusion in Castle Connolly’s Ameri-ca’s Top Doctors for Cancer, the new edition of which was published last fall.

Dr. O’Hea is a co-investigator of a new clinical trial titled “Evaluation of a Newly Designed Device for Breast Cancer Screening,” funded by the Carol M. Bald-win Foundation for Breast Cancer Research.

Cardiothoracic SurgeryDr. Thomas V. Bilfi nger, professor of surgery and director of thoracic surgery, is editor-in-chief of Ameri-can Journal of Case Reports, which recently was PubMed and Medline listed by the National Institutes of Health.

Dr. Bilfi nger is co-investi-gator of a new study titled “Postoperative Cognitive Defi cits: Exploring the Role of Hippocampal Neurogenesis,” for which a two-year research grant was recently awarded by the School of Medicine in con-junction with the Long Island Clinical and Translational Science Center.

Known as a Fusion Award, this competitive research grant is designed to sup-port highly meritorious and innovative research. Win-ners must demonstrate the potential applicability of the research to human health, and make clear the “critical path” plan that delineates the steps essential to translat-ing the research fi ndings to improved patient care.

Dr. Allison J. McLarty, associate professor of sur-gery, in April accomplished the successful implantation of the fi rst permanent left ventricular assist device (LVAD) to be performed on Long Island. This current LVAD engineering repre-sents a new generation of “artifi cial heart” technology that provides our end-stage heart disease patients with access to an important new opportunity for so-called destination therapy, an al-ternative to heart transplant.

Dr. Todd K. Rosengart, professor and chairman of surgery and chief of cardio-thoracic surgery, was again selected for inclusion in the Castle Connolly Guide, America’s Top Doctors, pub-lished in February.

Dr. Rosengart in March participated in the Advocacy Advisory Meeting of the American College of Cardiol-ogy, in the discussion titled “The Developments in Cardiac Therapy and Dis-ease Prevention around the World,” as part of the ACC Annual Scientifi c Ses-sion held in Atlanta, GA.

Dr. Rosengart in April chaired the American Heart Association’s National Bioengineering

and Biotechnology Study Group for the 2010 peer-re-view year. He was responsi-ble for guiding and directing the peer-review committee in the review of affi liate career development and project sup-port applications.

Dr. Rosengart in May served as the invited discussant of the study titled “Cardiac In-sulin Resistance as a Risk Factor for Heart Failure,” a presentation in the Cardiac Surgery Forum at the annual meeting of the American Association for Thoracic Surgery held in Toronto, ON, Canada.

Last fall, Dr. Rosengart was co-chair with SBUMC CEO Dr. Steven L. Strongwater of the successful Heart Walk and Community Forum, which attracted more than 1,200 people to West Campus in support of the fi rst Ameri-can Heart Association walk to be held in Suffolk County in the past six years.

Colon and Rectal SurgeryDr. Roberto Bergamaschi, professor of surgery and chief of colon and rectal surgery, has been selected for a second three-year term as an associate editor of Diseases of the Colon and Rectum, the prestigious journal on intestinal disor-ders that is published by the American Society of Colon and Rectal Surgeons.

Among Dr. Bergamaschi’s several international pres-entations (invited lectures) given in recent months are:

Abdominal surgery for rectal • prolapse. Latin American Congress of Coloproctology. Guayaquil, Ecuador.Advantages of laparoscopic sur-• gery for diverticulitis. Brazilian Symposium on Coloproctology. São Paolo, Brazil.

Is laparoscopy delivering? [key-• note lecture]. European Society of Coloproctology. Prague, Czech Republic.Treatment of rectal prolapse by • perineal procedures. Colorec-tal Congress 2009: Benign Colorectal Diseases. St. Gallen, Switzerland.

In March, Dr. Bergamaschi and colleagues from the Department gave the follow-ing poster presentations at this year’s “Residents Night” sponsored by the New York Society of Colon and Rectal Surgeons, held in New York:

Connexin 43 in human • colon cancer [authors: Karas J, Fakhoury M, Peter Brink, P, McNurlan M, Bergamaschi R].Impact of timing of Hartmann’s • reversal on postoperative ad-verse events [authors: Bishawi M, Karas J, Bergamaschi R].Intracorporeal right colectomy • for cancer in obese patients [authors: Kwon AO, Karas JR, Bishawi M, Denoya P, Berga-maschi R].Laparoscopic abdomino-• perineal resection for rectal cancer invading the sphincter [authors: Amrani S, Karas J, Yuan Q, Bergamaschi R].

Dr. Bergamaschi in Decem-ber was elected to the New York Surgical Society.

Dr. Marvin L. Corman, professor of surgery, was selected for the prestigious Best Doctors in America 2009-2010 database, which represents the top 5% of the nation’s practicing board-certifi ed physicians. He has received this high honor in the past, as well.

Dr. Corman spoke last Octo-ber in Montreal, Canada, at the Jewish General Hospital at the 46th Annual André Aisenstadt Memorial Clini-cal Day on advances in the treatment and manage-ment of colorectal cancer. That month he also was visiting professor at Santa

The Stony Brook Ambulatory Surgery Center continues to rank as #1 in the nation for patient satisfaction, based on the 2009 data of the University HealthSystem Consortium.



Barbara Cottage Hospital in Santa Barbara, CA, for dis-cussion of interesting cases.

Dr. Paula I. Denoya, as-sistant professor of surgery, last November gave a presentation titled “Right Hemicolectomy with In-tracorporeal Anastomosis in Obese Cancer Patients” at the annual meeting of the Northeastern Society of Colon and Rectal Surgeons Annual Meeting held in Delray Beach, FL.

Starting in May, Dr. Denoya and Dr. William B. Smithy will be seeing patients at our new offi ce in Smith-town, NY.

General Surgery,Trauma, SurgicalCritical Care, and BurnsDr. Evan R. Geller has rejoined our faculty, on a part-time basis, as associate professor of surgery. He will help cover the SICU, and also will contribute to our educational mission, provid-ing education to our medical students, residents, and criti-cal care fellows. Dr. Geller originally joined our faculty in 1987, and served as chief of trauma from 1990 to 1996.

Dr. Jared M. Huston, as-sistant professor of surgery, won the American Asso-ciation for the Surgery of Trauma (AAST) Research and Education Scholarship for the academic year 2010-11. The title of his project is “Cholinergic Regulation of Lethal Abdominal Hemor-rhage.” AAST (est. 1938) is considered the leading scientifi c trauma society in the world.

Dr. Michael F. Paccione, assistant professor of surgery, has accepted a joint appointment with the Department of Oral Biology and Pathology.

Dr. Paccione is a co-investi-gator of a new basic science study titled “Multifunc-tional Electrospun Scaf-folds for Tissue Regenera-tion,” funded by a two-year research grant recently awarded by the School of Medicine in conjunction with the Long Island Clinical and Translational Science Center.

This competitive research grant is a Fusion Award (see page 12, top of second column from left, for description).

Dr. Steven Sandoval, as-sistant professor of surgery and medical director of the Burn Center, was quoted in Newsday about the care given to Jesus Cabrera, local hero, who helped a young

mother rescue her infant out of a burning house despite his own severe burn injuries.

The patient spent two months here in the Burn Center, during the fi rst of which he was in a medi-cally induced coma and his prognosis was guarded.

“Those type of injuries are not very survivable, with mortality greater than 50%,” said Dr. Sandoval. But thanks to the burn care he received from our team, he did survive and, after months of hospitalization, was fi nally able to return home.

Dr. Marc J. Shapiro, profes-sor of surgery and anesthe-siology, has been named as-

sistant chief quality offi cer of Stony Brook University Medical Center.

In this new role, which is an outgrowth and broadening of his earlier and ongoing efforts with numerous quality assurance initiatives at Stony Brook, Dr. Shapiro concen-trates on hospital issues particularly but not solely related to surgical quality, pa-tient safety, and performance improvement.

Dr. Shapiro was selected as one of the recipients of the Presidential Citation of the Society of Critical Care Medi-cine for his “extraordinary contributions of time, energy, and resources” to the society during 2009.

CME Saturdays—Great Success!Furthering Our Missions of ExcellenceIn Education and Community Service

Our new educational pro-gram offering community physicians and surgeons free continuing medical education (CME) opportunities has been a great success. Called CME Saturday Surgical Seminars, the lecture series runs through June. Based on its success, the program will be continued in the next academic year in collabora-tion with the Department of Medicine.

This monthly program features updates presented by faculty from each of our divisions.

Our CME Saturday in December included hands-on simulation experience with inserting a central line.

GREG

ORY

FILI

ANO

| M

EDIA

REL

ATIO

NS

continued on Page 14

group with a rundown on ways to effectively treat lacerations and burns, distinguishing the most serious injuries that re-quire surgical intervention from those that can be cared for effec-tively in the physician’s offi ce.

The hands-on portion of the seminar featured practice on completing sutures and on how to manipulate a laparoscope for surgery, as well as techniques for central line placement and intubation in simulated patient mannequins.

Dr. Fatema P. Meah, of Peconic Pediatrics in Riverhead, NY, expressed what most of the 20 or so pediatricians experienced during the two-hour CME: “The training is great practice but also gives us as pediatricians more insight to the most serious cases and procedures that are usually done outside our offi ces, such as laparoscopic surgery.”

Our pediatric surgery semi-nar, for instance, which took place last December, was well attended and much appreciat-ed by community physicians.

The seminar offered a dynam-ic hands-on session held at Stony Brook’s Clinical Skills Center. This CME provided local pediatricians training in “Offi ce Procedures for Pediatricians: Do’s, Don’ts, and Hands-On Simulation Experience.”

Our pediatric surgeons, Drs. Thomas K. Lee and Richard J. Scriven, fi rst provided the

Focusing on the latest advances in surgery and the new options for patients, our CME Saturdays have attracted a growing audience of interested community physicians, as well as physicians and other healthcare professionals at Stony Brook.



Otolaryngology-Head and Neck SurgeryDr. Elliott Regenbogen, assistant professor of surgery, in April presented his paper, “Geriatric Patient-Centered Care in a Tertiary Care Center,” at the fourth annual meeting of the American So-ciety of Geriatric Otolaryngol-ogy, held in Las Vegas, NV.

Dr. Ghassan J. Samara has been promoted to associate professor of surgery. Dr. Samara won the fi rst-place poster award for his presentation, “Alcohol Induces Reactive Oxygen Species and Migration in Keratinocytes,” in May at the annual meeting of the Triological Society, held in Las Vegas, NV. Co-authors are second-year medical student Alex Helkin (fi rst author) and Dr. Hoang-Lan Nguyen, research scientist in the Department of Medicine’s cancer prevention division.

Dr. David A. Schessel, associate professor sur-gery and acting chief of otolaryngology-head and surgery, was selected for the prestigious Best Doctors in America 2009-2010 database, which represents the top 5% of the nation’s practicing board-certifi ed physicians.

Pediatric SurgeryDr. Richard J. Scriven, as-sociate professor of surgery and director of residency training in general surgery, has accepted a joint ap-pointment with the De-partment of Pediatrics.

Plastic andReconstructive SurgeryDr. Alexander B. Dagum, professor of surgery and or-thopaedics and chief of plastic and reconstructive surgery, was again selected for inclu-sion in the Castle Connolly Guide, America’s Top Doctors, published in February.

Dr. Dagum contributed to the success of the follow-ing study that last Decem-ber was the winner of the poster presentation competition at the Nassau Surgical Society and Brook-lyn and Long Island Chapter of the American College of Surgeons Annual Clinic Day held in Uniondale, NY:

Comparing the relative impor-• tance of suture technique, su-ture material and the number of strands in the repair of fl exor tendons [authors: Haimovici L, Papafragkou S, DagumAB, Hurst LC].

In April, Dr. Dagum served as co-director of the 12th An-nual Cleft Palate-Cranio-facial Center Symposium, sponsored by the School of Medicine’s Offi ce of Con-tinuing Medical Education. A great success as in the past, the symposium focused on the importance of the team approach to the management of cleft lip/palate and cranio-facial anomalies.

This May Dr. Dagum travels once again to China to per-form pro bono surgery to repair cleft lips and palates and also burn injuries. It will be his sixth mission there.

Dr. Sami U. Khan, assis-tant professor of surgery and director of cosmetic surgery, last fall presented his study titled “Offi ce-Based Surgery: Is It Really Safe? Lessons Learned from the Plastic Surgery Community,” at the Annual Meeting of the Mayo Clinic Alumni Association and the Priestley Surgical So-ciety held in Scottsdale, AZ.

In addition, Dr. Khan in recent months presented the following two studies con-ducted with his Stony Brook colleagues:

The effect of acellular dermal • matrix use on complication rates in tissue expander/implant breast reconstruction [authors: Lanier ST, Wang ED, Chen JJ, Arora BP, Katz SM, Gelfand MA, Khan SU, Dagum

AB, Bui DT]. Annual Meeting of the Northeastern Society of Plastic Surgeons. Charleston, SC.Outcomes of lower-extremity • trauma reconstruction with Taylor spatial frame fi xator and muscle fl aps [authors: Melendez MM, Xu X, Gonzalez M, Divaris N, Kottmeier S, Khan S, Bui D, Dagum AB]. Congress of the World Society for Reconstruc-tive Microsurgery. Okinawa, Japan.

Since last fall, Dr. Khan has been serving as a reviewer for Plastic and Reconstructive Surgery, the offi cial journal of the American Society of Plastic Surgeons. Additional current service includes participation on the young plastic surgeons steering committee; patient safety committee; health policy committee; and coding com-mittee.

Upper Gastrointestinal and GeneralOncologic Surgery Dr. Colette R.J. Pameijer, assistant professor of sur-gery, in January was fi lmed in the operating room perform-ing the heated intraperitoneal chemotherapy (HIPEC) pro-cedure, for an interview with her about it on Fox TV.

HIPEC is an innovative combination of surgery and chemotherapy used for treat-ing tumor that have spread to the lining surfaces of the peritoneal (abdominal) cav-ity from primary colorectal cancer, gastric cancer, and appendiceal cancer, or meso-thelioma.

Dr. Pameijer last summer was on News 12 discussing the proposed new legislation ban-ning teens under the age of 18 from using sun-beds. She is increasingly sought after by the media for her exper-tise in melanoma and her commitment to prevention plus the latest therapeutic advances.

Vascular SurgeryDr. Antonios P. Gasparis, associate professor of sur-gery and director of the Stony Brook Vein Center, has

been named assistant chief medical offi cer for clinical resource management of Stony Brook University Medi-cal Center.

In this new role, Dr. Gasparis participates in quality improve-ment and quality assurance activities and projects related to the delivery of high-quality, cost-effective care.

Dr. Gasparis and his vascular colleague Dr. Nicos Labro-poulos, professor of surgery and radiology and director of the Non-Invasive Vascular Lab-oratory, served as co-directors of the very successful First Annual Venous Symposium, which took place in March in Islandia, NY. Attendance of the seminar approached 200, with standing room only.

The focus of the symposium, sponsored by Stony Brook’s Offi ce of Continuing Medical Education, was venous throm-boembolism. The distinguished faculty of international vascular specialists provided the latest recommendations on the pro-phylaxis and treatment of this too-often deadly condition.

The symposium was a trail- blazing event establishing Stony Brook as a thought-leader in this important area of investigation and treatment.

Dr. Apostolos K. Tassio-poulos, associate professor of surgery and chief of vascular surgery, last fall gave the follow-ing four podium presentations at the International Symposium on Vascular Diseases, Abano Therme, Italy:

Prosthetic grafts for lower • extremity bypass in patients with compromised vein.The role of a modern • vascular center.Treatment of long lower • extremity arterial lesions.Ultrasound-guided arterial • endovascular interventions.

Dr. Tassiopoulos has assumed a leadership role in the de-velopment of our Surgical Simulation Center, which will serve as an essential training resource for medical students and surgical residents.



OUR ELECTRONIC PHYSICIAN DIRECTORYThe Department provides a physician directory as part of its website—please visit us at the following address to fi nd in-formation about our individual surgeons (see sample below), as well as our programs in patient care, education, research, and community service:

www.StonyBrookSurgery.org

Dr. Colette R.J. Pameijer

MD: Medical College of Pennsylvania (1995).Residency Training: General Surgery, Medical College of Pennsylvania-Hahnemann University Hospitals, Philadelphia, PA; University of Wisconsin Hospital and Clinics, Madison, WI.Fellowship Training: Surgical Oncology, City of Hope National Medical Center, Duarte, CA.Board Certifi cation: Surgery.Specialties: Management of cancers of the upper gastrointestinal tract, soft tissue, melanoma (including surgery and minimally invasive limb infusion for recurrent melanoma limited to an extremity), and breast (including breast conservation surgery, sentinel node biopsy, and minimally invasive

radiation therapy for early breast cancer); heated intraperitoneal chemotherapy (HIPEC); treating advanced malignancies; palliative surgery.Additional: See selected recent publications.Honors: Selected for inclusion in the Guide to America’s Top Surgeons published by the Consumers’ Research Council of America.Languages Spoken: English, Dutch.Consultations/Appointments: 631-444-8086.

Saturday Surgical Seminar Series

Our Saturday Surgical Seminar Series offers continuing medical education (CME) credit through the School of Medi-cine of Stony Brook University. This activity is designated for a maximum of 2 AMA PRA Category 1 Credits™.

The seminars—held on the second Saturday of each month, from 8:00 to 10:00 am, at Stony Brook University Medical Center—provide lectures and discussion on topics covering the full range of current surgical concerns.

The focus of each seminar is on what referring physicians need to know about the latest advances in surgery, in terms of the new options available for patients.

For more information, please call (631) 444-2037.

Surgical Grand Rounds

Our Surgical Grand Rounds program offers CME credit through the School of Medicine of Stony Brook University. This activity is designated for a maximum of 1 AMA PRA Category 1 Credit™.

The weekly Surgical Grand Rounds lectures are generally held on Wednesday morning, from 7:00 to 8:00 am, in the Health Sciences Center (level 3, lecture hall 6).

Topics cover the full range of current surgical concerns, focusing on clinical issues of interest to practicing physicians and surgeons. Featured speakers include distinguished visit-ing professors from the nation’s top universities and medical centers.


Trauma Conference

The Trauma Conference of the Division of General Surgery, Trauma, Surgical Critical Care, and Burns offers CME credit through the School of Medicine of Stony Brook University. This activity is designated for a maximum of 1 AMA PRA Category 1 Credit™.

The weekly conferences are generally held on Friday morn-ing, from 7:00 to 8:00 am, in the Health Sciences Center in the trauma conference room (level 18, room 040).

Topics cover the full range of concerns related to the trau-ma/critical care environment, including thoracic injuries, ICU administration/billing, and case histories. Presentations are made by attending physicians, as well as other medical professionals.


Conducting Genetic ResearchTo Enhance Arteriogenesiscontinued from Page 9

Research that, hopefully, can be translated into gene therapy to stimulate the heart’s growth of new blood vessels—to create a “biologic” coronary bypass.

Robert Gersch, PhD, re-search assistant professor of surgery, who is the basic and translational research scien-tist in charge of Dr. Rosen-gart’s laboratory, explains:

“Research now underway in our lab involves cellular analysis as well as a femoral ligation model. We hope to study Egr-1’s role in arterio-genesis by altering its expres-sion level in these systems and comparing the reaction

to occlusion in the treatment groups with a normal control group.

“Future work will focus on a myocardial ischemia model in which the slow occlusion build-up observed in heart disease is mimicked. By using this model, we can target and modulate the expression of Egr-1 and its target genes with the goal of improving the arteriogenic response.”

Dr. Rosengart’s arteriogenesis lab is currently supported by the National Institutes of Health—it is one of only 25 NIH-funded cardiac surgery labs in the country—and his research team includes both residents and stu-dents, in addition to Dr. Gersch.


The State University of New York at Stony Brook is an equal opportunity/affi rmative action educator and employer. This publication can be made available in an alternative format upon request.

Please visit the Department of Surgery website at www.StonyBrookSurgery.org

Stony Brook Surgical Associates

MED

IA S

ERVI

CES

| ST

ONY

BROO

K UN

IVER

SITY

www.StonyBrookPhysicians.com

BREAST SURGERY(631) 638-1000 (tel)(631) 638-0720 (fax)Martyn W. Burk, MD, PhDPatricia A. Farrelly, MDBrian J. O’Hea, MDChristine R. Rizk, MD

BURN CARE(631) 444-4545 (tel)(631) 444-6176 (fax)Steven Sandoval, MDMarc J. Shapiro, MD

CARDIOTHORACIC SURGERY(631) 444-1820 (tel)(631) 444-8963 (fax)Thomas V. Bilfi nger, MD, ScDSandeep Gupta, MDAllison J. McLarty, MDTodd K. Rosengart, MDFrank C. Seifert, MD

COLON AND RECTAL SURGERY(631) 638-1000 (tel)(631) 444-4545 (tel)(631) 444-6348 (fax)Roberto Bergamaschi, MD, PhDMarvin L. Corman, MDPaula I. Denoya, MDWilliam B. Smithy, MD

GENERAL SURGERY(631) 444-4545 (tel)(631) 444-6176 (fax)Jared M. Huston, MDLouis T. Merriam, MDMichael F. Paccione, MDSteven Sandoval, MDMarc J. Shapiro, MDJames A. Vosswinkel, MD

OTOLARYNGOLOGY-HEADAND NECK SURGERY (ENT)(631) 444-4121 (tel)(631) 444-4189 (fax)Elliot Regenbogen, MDGhassan J. Samara, MDDavid A. Schessel, MD, PhD

PEDIATRIC SURGERY(631) 444-4545 (tel)(631) 444-8824 (fax)Thomas K. Lee, MDRichard J. Scriven, MD

PLASTIC ANDRECONSTRUCTIVE SURGERY(631) 444-4666 (tel)(631) 444-4610 (fax)Duc T. Bui, MDAlexander B. Dagum, MDJason C. Ganz, MDMark A. Gelfand, MDSteven M. Katz, MDSami U. Khan, MD

PODIATRIC SURGERY(631) 444-4545 (tel)(631) 444-4539 (fax)Valerie A. Brunetti, DPMBernard F. Martin, DPM

TRAUMA/SURGICALCRITICAL CARE(631) 444-4545 (tel)(631) 444-6176 (fax)Evan R. Geller, MDJared M. Huston, MDLouis T. Merriam, MDMichael F. Paccione, MDSteven Sandoval, MDMarc J. Shapiro, MDJames A. Vosswinkel, MD

UPPER GASTROINTESTINALAND GENERAL ONCOLOGICSURGERY(631) 638-8086 (tel)(631) 444-6348 (fax)Philip Bao, MDColette R.J. Pameijer, MDKevin T. Watkins, MD

VASCULAR SURGERY(631) 444-4545 (tel)(631) 444-8824 (fax)Antonios P. Gasparis, MDMazen M. Hashiso, MDDavid S. Landau, MDApostolos K. Tassiopoulos, MD

OFFICE LOCATIONSSurgical Care Center37 Research WayEast Setauket, NY 11733(631) 444-4545 (tel)(631) 444-4539 (fax)

Cancer Center /Carol M. BaldwinBreast Care Center3 Edmund D. Pellegrino RoadStony Brook, NY 11794(631) 638-1000 (tel)(631) 444-6348 (fax)

Plastic & CosmeticSurgery Center / Vein Center24 Research Way, Suite 100East Setauket, NY 11733(631) 444-4666 (tel)(631) 444-4610 (fax)

Smithtown Offi ce222 Middle Country RoadSuite 209Smithtown, NY 11787(631) 444-4545 (tel)(631) 444-4539 (fax)

Outpatient Services Center225 West Montauk HighwayHampton Bays, NY 11946(631) 723-5000 (tel)(631) 723-5010 (fax)

DEPARTMENT OF SURGERYSTONY BROOK UNIVERSITYMEDICAL CENTER Stony Brook, NY 11794-8191

Nonprofi t Organization

U.S. Postage

PAID

Stony Brook University

Permit #65

Free CME OpportunitiesSee Pages 13 & 15


advancing minimally invasive oncologic surgery...using robotics to remove gi tumors with minimally...

Documents